An ankle joint may become severely damaged and may be treated by total ankle replacement. One type of total ankle replacement comprises two components; one part is implanted in a resected tibia and the other part is implanted in a resected talus. The talar implant can include a stem and/or one or more pegs, screws or combinations of pegs, screws and stem that extend into openings drilled into the resected surface of the bone. In some patients, the quality of the bone into which the pegs are to be inserted is poor.